Introduction: Currently, an increasing number of studies point to the prevalence of neurological manifestations associated with COVID-19, including stroke. Although the pathophysiology is not completely understood, the infection induces a prothrombotic state stimulate by high levels of factor VIII, fibrinogen and Ddimer. In this sense, high mortality (44,2%) is a challenging context and identify influences of clinical and morphological aspects the outcome of these patients. Design and setting: Literature review conduced in Barão de Mauá University Center, Ribeirão Preto-SP. Objective: Clarifying aspects involved in the pathogenesis and clinical manifestations in patients with COVID-19 and Stroke. Methods: The primary databases utilized to retrieve the salient medical literature presented in this review were Scielo and Pubmed. The search terms, included “stroke”, “SARS-CoV”, “covid-19”. Discussion: Ischemic stroke was the most common subtype found associated with multiple infarctions and cryptogenic etiology. The mechanisms are multifactorial, including conventional pathways stimulated by the pathogen or direct action. Called “sepsis coagulopathy”, activation of the coagulation pathway associated with viral invasion of endothelial cells and excessive release of cytokines causes a prothrombotic state. Hemorrhagic stroke is less common. It is believed that the affinity of SARS-coV- 2 for ACE2 (angiotensinconverting enzyme 2) receptors could directly damage intracranial arteries, causing rupture, associated with fibrinogen depletion and massive release of cytokines and proteases. Conclusion: Individuals affected by COVID-19 that are affected by stroke face more severe conditions and worse associated outcomes. Thus, understanding the pathophysiology and clinical aspects brings greater effectiveness in the care of these individuals and lower mortality.